Provider Demographics
NPI:1912577982
Name:THE FAMILY CENTER OF AIKEN COUNTY
Entity Type:Organization
Organization Name:THE FAMILY CENTER OF AIKEN COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:803-752-0404
Mailing Address - Street 1:1117 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-3012
Mailing Address - Country:US
Mailing Address - Phone:803-752-0404
Mailing Address - Fax:888-384-2250
Practice Address - Street 1:1117 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-3012
Practice Address - Country:US
Practice Address - Phone:803-752-0404
Practice Address - Fax:888-384-2250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPL1369Medicaid
SC1376642884OtherPROVIDER ID #